Birth to 3

Birth to 3

Birth to 3 provides in-home therapy and education to Washington County families who have a child under the age of three who may be falling behind in development.  Families may have questions regarding their child’s development, and staff from our Birth to 3 program can help answer those questions. The goal of our program is to provide support and guidance to parents and other caregivers that will help with their child’s daily routines and activities in ways that will promote optimal growth and development within the environment they are most comfortable….. their home. Services are voluntary and are provided at little or no cost to families.

We are proud of our Birth to 3 Program staff for consistently meeting and in some circumstances exceeding compliance and performance indicators set forth by the Department of Human Services!

Please click here to view the letter from the State of WI Department of Health Services. 

Congratulations to our Birth to 3 Staff for meeting state requirements (click here to see a copy of the letter), scoring in the top percentile of their Annual Performance Report (APR) Indicator Performance!!!  It is apparent that you do excellent work and should be commended!  We are proud of you!

Please take note of the last paragraph which describes our “exemplary services to children amid various challenges.”


“I loved the fact that ultimately, I was in control of deciding what to work on with my boys, but most importantly I was shown how to do it! I learned so much! When you work hard and the result of that hard work is the success of your child, you just push that much harder for the next “aha moment!” we had a lot of “aha moments, thanks to birth to 3 🙂 ” 
-Nikki B.


Birth to 3 is funded by United Way, please click here to see how those funds are used to help children.

What exactly is Birth to 3?

Birth to 3 began in 1986 and is a federally mandated program under Part C of the Individuals with Disabilities Education Act (IDEA).

How do families get connected to the program?

Families are typically referred by their child’s pediatrician, but anyone can refer a child to the program.

What services does Birth to 3 provide?

  • Service Coordination
  • Special Instruction
  • Physical Therapy
  • Speech Therapy
  • Occupational Therapy
  • Family Education through an Early Childhood Special Ed Teacher

What do services look like and how often do they occur?

Services are individualized because every child and family needs differing levels of support. Services are provided in the home with the parent, but in some situations we may provide services in a childcare or other community setting.

What happens when my child turns 3?

We will begin planning your child’s transition and will walk you through the necessary steps after your child turns 2. Children generally transition from Birth to 3 into a school-based service through their local school district, but that is not the only option. Our staff will share other options with you at that time.

What happens if my child does not qualify for Birth to 3?

Birth to 3 provides your family with information on other services and resources in the area. Our program may offer a re-evaluation of your child’s eligibility after a two month waiting period.

We partner with the following agencies to assure the best care for the children in our program.


  • Washington County Human Services
  • United Way of Washington County
  • Rehab Resources, Inc.
  • Early Head Start
  • Saint A
  • Family Center of Washington County
  • School Districts
  • Hear Wisconsin
  • Cooperating Education Service Agencies 6 & 1
  • Wisconsin Dept. of Health Services-Birth to 3



Birth to 3 Director, 262-338-1188, ext 524 or

Washington County Birth to Three Embraces IMH Principles

Contributed by Michael Hoffman, Director of Birth to Three, Washington County

This vision started in the Summer of 2005 when I attended a course, “Social Emotional Development in Children Ages Birth to 6: Nurturing Relationships and Recognizing Concerns and Boundaries.” As a Birth to 3 teacher with less than two years’ experience, the session introduced me to the topic of infant mental health. We began by reading “Ghosts in the Nursery” and an activity for which we were instructed to look at the youngest picture of ourselves we could find. After silently looking at the picture, we answered these questions:
• What do you know about who held you as a young child (physically, emotionally?)
• What are some of the many ways that people are “held” by others (arms, eyes, voice)?
• How might you have wanted to be held?
• How might your early experiences have effected who you are today?
• How have these experiences effected your relationships with others?

This exercise opened a door that I had never explored. Tears, tingles, suffocation and clarity overwhelmed me while doing this activity and I was never the same. This was something and I wanted more!
Diane Fett then encouraged me to apply for the UW Infant, Early Childhood and Family Mental Health Capstone Certificate Program. I met wonderful, smart and talented professionals in my program cohort. I often looked around and thought, “Help is on the way. We are going to do some great things in our respective fields.” With each cohort, came more graduates and more boots on the ground. I continued to think, “Help is on the way.”
Our program has been fortunate to secure funding to send five staff through the certificate program and another two start in Fall, 2017. “Help is on the way!” In 2013 we were fortunate enough to begin work with a reflective supervision consultant, Tricia Schutz, and our group dynamic started to shift. We changed our work with families by reshaping our family history and assessment practices to look for, and ask about, families’ experiences. We utilized various assessment tools for greater knowledge of how children function socially and emotionally. We put a greater emphasis on the relationship between the Birth to 3 service provider and the family.
We listened to parents’ tone of voice and phrases used to describe their child on the first referral phone call. This often prompted evaluation, using the NBO (Newborn Behavioral Observation), when in the past we may have ‘screened the child out’ on that call. We started thinking about how a parent with a history of trauma may fit, or not fit, our program rules and regulations.
Our work and work culture have positively changed, but we were too engaged to notice, until we were asked to present our work at a SE Chapter meeting. We reflected on where we came from, much like that first activity in 2005. We support each other and keep infant mental health ‘front of mind’ in our services and the decisions we make. As one team member, Ashley aptly stated, “The work reinforces the work”!

This article was: Written By Michael Hoffman, Director of Birth to 3, for the Southeast Chapter newsletter “Bright Beginnings” of the Wisconsin Alliance for Infant Mental Health. 

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